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Insurance - American Integrated Services, Inc. - 2018-12-26�C`�IVE JAN 0 7 2018 Costa AAJ).&- C ACORL° CERTIFICATE OF LIABILITY INSURANCE r �Ylstrtct 16*.� 9/1/2019 DATE(MM/DD/YYYY) 1 12/26/2018 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WANED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER LOCIdon JnSuiarloe makers, LLC 725 S. Figueroa Street, 35th A. CA License # T15767 Los A 64eles 00 CA 917 (213) 89 O CONTCT N EA A/C, No Ext : AIC No E-MAIL N RE AFFORDING COVERAGE NA INSURER A : Starr Surplus Lines Insurance Company 13604 INSURED An-BiC@n Int SerViC,, Inc 1319084 1502 E SPP WIrdrlgton CA 90744 927 INSURER B: Starr Indemnity & Liability Company 38318 INSURER C: Hartford Fire Insurance Company/ 19682 INSURERD: 12/27/2018 INSURER F rnvFZQer_I=c n nn H4I nins f CDT1UIf'ATC All IIIARCD. 1 C[%UAAAA oC1n01^K1 kn lamocn. YYvvYYV THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR NCE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF POLI(MMIDCY EXPLTR LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS MADE � OCCUR X Poll./Prof. Liab, X I Ded: $10.000 y N 1000066049181 12/27/2018 12/27/2019 EACH OCCURRENCE 1,000,000 PRISES TO RENTED 1,000,000 MED EXP (Any oneperson) 5,000 PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: F__] LOC POLICY PRO- JECT OTHER: GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP/OP AGG $ 2,000,000 $ B AUTOMOBILE LIABILITYCOMBINED X ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS X AUTOS ONLY X NON-OWNED ONLY X Comp/Coll D d: $ 5K Y N SISIPCA08222818 12/27/2018 12/27/2019 SINGLE LIMIT Ea accident $ 1,000,000 BODILY INJURY (Per person) $ XXXXXXX BODILY INJURY Per accident $ XXXXX� ( PROPERTY acEcidentDAMAGE $ XXXYI= $ Xxxxxxx A X UMBRELLA LIAB EXCESS LIAB [NOCCUR CLAIMS -MADE N N 1000336805171 12/27/2018 12/27/2019 EACH OCCURRENCE $ 20A0,000 AGGREGATE $ 20,000,000 DED I I RETENTION $ $ V00cx x B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N � ICERIMEMBER EXCLUDE/ED? ECUTIVE FY -1 (MIf andatory in NH) DESbe under CRIPTION OF OPERATIONS below N / A N 100000294201 9/1/2018 9/1/2019 X PER ER E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE 1,000,000 E.L. DISEASE -POLICY LIMIT 1,000,000 C Scheduled Equipment/L&R N N 72UUMPT4095 12/27/2018 12/27/2019 Equipment Limit: $8,324,067; L&R: 500I,,Ded.$1,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required) THIS CERTIFICATE SUPERSEDES ALL PREVIOUSLY ISSUED CERTIFICATES FOR THIS HOLDER, APPLICABLE TO THE CARRIERS LISTED AND THE POLICY TERM(S) REFERENCED. Contractor's Pollution and Professional Liability is included in the GL policy: $1 MM Ea Occ, $2MM Agg, with $10,000 Ded. RE: All Operations. The Costa Mesa Sanitary District, its elected and appointed officials, agents, officers, volunteers and employees are Additional Insured(s) as per the attached endorsement or policy language. Insurance provided to Additional Insured(s) is primary and non-contributory as per the attached endorsements or policy language. GCK I IrIUA I It: MULULK CANCELLATION See Attachments SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 15596464 AUTHORIZED REPRESENTATIVE Costa Mesa Sanitary astrict" a%l°� 290 PaLitarino Avenue J' I Costa Mesa CA 92626 ACORD 25 (2016/03) ©1 A8-2015--ACORD C RPORATION. All riahts reserved The ACORD name and logo are registered marks of ACORD POLICY NUMBER: 1000066049181 COMMERCIAL GENERAL LIABILITY CG 2012 0413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - STATE OR GOVERNMENTAL AGENCY OR SUBDIVISION OR POLITICAL SUBDIVISION - PERMITS OR AUTHORIZATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE State or Political Subdivision: Where Required By Written Contract (Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II - Who Is An Insured is amended to include as an additional insured any state or governmental agency or subdivision or political subdivision shown in the Schedule, subject to the following provisions: 1. This insurance applies only with respect to operations performed by you or on your behalf for which the state or governmental agency or subdivision or political subdivision has issued a permit or authorization. However: a. The insurance afforded to such additional insured only applies to the extent permitted by law; and b. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. CG 2012 0413 Attachment Code: D517373 Certificate ID : 15596464 2. This insurance does not apply to: a. "Bodily injury", "property damage" or "personal and advertising injury" arising out of operations performed for the federal government, state or municipality; or b. "Bodily injury" or "property damage" included within the "products -completed operations hazard". B. With respect to the insurance afforded to these additional insureds, the following is added to Section III - Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement; or 2. Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. © Insurance Services Office, Inc., 2012 Page 1 of 1 Attachment Code: D501438 Certificate ID : 15596464 Starr Surplus Lines Insurance Company Chicago, IL 1-646-227-6300 Primary and Non-contributory Condition Policy Number: 1000066049181 Effective Date: 12/27/2018 Named Insured: American Integrated Services, Inc.; AIS-TN&A; Azetca LB1, Inc.; Azetca LB2, Inc. This endorsement modifies insurance provided under the: Commercial General Liability Coverage Form A. SECTION IV - CONDITIONS, condition 4. Other Insurance is amended as follows: 1. The following is added to paragraph 4.a. of the Other Insurance condition: This insurance is primary insurance as respects our coverage to the additional insured, where the written contract or written agreement requires that this insurance be primary and non-contributory. In that event, we will not seek contribution from any other insurance policy available to the additional insured on which the additional insured is a Named Insured. ALL OTHER TERMS AND CONDITIONS REMAIN UNCHANGED. SL - 707 (04/11) Page 1 of 1 Copyright © C. V. Starr & Company and Starr Surplus Lines Insurance Company. All rights reserved. Includes copyrighted material of ISO Properties, Inc., used with its permission. Starr Indemnity & Liability Company THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. Policy Number: SISIPCA08222818 Effective Date: 12/27/2018 Named Insured: American Integrated Services, Inc.; AIS-TN&A; Azetca 1-131, Inc.; Azetca 1-132, Inc. ADDITIONAL INSURED - WHERE REQUIRED UNDER CONTRACT OR AGREEMENT This policy is amended as follows: BUSINESS AUTO COVERAGE FORM SCHEDULE ADDITIONAL INSURED ANY PERSON OR ORGANIZATION FOR WHOM YOU ARE CONTRACTUALLY BOUND TO PROVIDE ADDITIONAL INSURED STATUS BUT ONLY TO THE EXTENT OF SUCH PERSON OR ORGANIZATION LIABILITY ARISING OUT OF THE USE OF A COVERED "AUTO" 1. SECTION II - LIABILITY COVERAGE A. Coverage, 1. Who is Insured, is amended to add: d. Any person or organization, shown in the schedule above, to whom you become obligated to include as an additional insured under this policy, as a result of any contract or agreement you enter into which requires you to furnish insurance to that person or organization of the type provided by this policy, but only with respect to liability arising out of use of a covered "auto". However, the insurance provided will not exceed the lesser of - (1) f (1) The coverage and/or limits of this policy, or (2) The coverage and/or limits required by said contract or agreement. SICA 1016 (02/12) Copyright © C. V. Starr & Company and Starr Indemnity & Liability Company. All rights reserved. Includes copyrighted material of ISO Properties, Inc., used with its permission. Attachment Code: D472048 Certificate ID : 15596464 Page 1 of 1 Starr Indemnity & Liability Company THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. INSURANCE PRIMARY AS TO CERTAIN ADDITIONAL INSUREDS Policy Number: SISIPCA08222818 Effective Date: 12/27/2018 Named Insured: American Integrated Services, Inc.; AIS-TN&A; Azetca 1-131, Inc.; Azetca 1-132, Inc. ADDITIONAL INSURED - WHERE REQUIRED UNDER CONTRACT OR AGREEMENT This policy is amended as follows: BUSINESS AUTO COVERAGE FORM Section IV - Business Auto Conditions, B., General Conditions, 5., Other Insurance, c., is amended by the addition of the following sentence: The insurance afforded under this policy to an additional insured will apply as primary insurance for such additional insured where so required under an agreement executed prior to the date of accident. We will not ask any insurer that has issued other insurance to such additional insured to contribute to the settlement of loss arising out of such accident. All other terms and conditions remain unchanged. SICA 1017 (02/12) Copyright © C. V. Starr & Company and Starr Indemnity & Liability Company. All rights reserved. Page 1 of 1 Includes copyrighted material of ISO Properties, Inc., used with its permission. Attachment Code: D507015 Certificate ID : 15596464